<ol id="sections">
    <li class="section">
        <div class="dp-content">
            <div id="my-account">
                <div id="appointment-body">
                    <div id="header-verify-appointment">
                        <?php include_partial("progress_bar", array("isSignIn" => true, "step" => "three")) ?>
                        <div id="appointment-left">
                            <?php include_partial("appointment_details", array("doctorTimeSlot" => $doctorTimeSlot, "bookNowDetails" => $bookNowDetails)) ?> 
                        </div>
                        <div id="appointment-right">                            
                            <form id="step-one-form" action="<?php echo url_for('/appointment-book-now-step-three') ?>" method="post">
                                <?php echo $form->renderHiddenFields(false) ?>
                                <div class="imperative">Have you any notes for the doctor?</div>
                                <?php include_partial("common/input_field", array("form" => $form, "field" => "note_by_Member", "show_label" => false)) ?>
                                <div class="imperative">Would you want to be reminded 30 minutes before the appointment time?</div>
                                <?php include_partial("common/checkbox_field", array("form" => $form, "field" => "has_reminder")) ?>
                                <?php include_partial("common/submit_button", array("id" => "submit", "value" => "Proceed")) ?>
                            </form>
                        </div>
                        <div class="clear"></div>
                    </div>
                </div>
                <?php include_partial("common/social_media") ?>
            </div>
        </div>
    </li>
</ol>